Macquarie MD Research Program

Macquarie MD Research Program

The Research Program introduced for the Macquarie MD in 2018 ensures students focus on research that aligns with MQ Health’s strategic goal – to undertake research that improves the delivery of healthcare and the quality of patient and broader community lives.   

Why was the program undertaken?

The purpose of the Macquarie MD Research Program is to develop future medical doctors who understand the role and importance of research in guiding evidenced-based medicine (EBM) practice.

The Macquarie MD Research Program is built around the overarching Macquarie MD, building on the capacity for graduates to become scholars, research-informed practitioners and applied medical scientists. Students have the opportunity to undertake research projects that align with the broad spectrum of research strengths within MQ Health [1] and the Australian Institute of Health Innovation (AIHI), both of which promote MQ Health’s strategic goal – to undertake research that improves the delivery of healthcare and the quality of patient and broader community lives.

The stimulating research environment offered to students enrolled in the MD ensures that they will develop research skills, plan and implement a research project, and communicate their research findings and recommendations for healthcare and/or future research.

How was the project implemented?

Research knowledge and skill development is embedded throughout the Macquarie MD, culminating with the completion and presentation of a substantial research project. The program organises research training into Stage 1 (Years 1 and 2 of the course) and the completion and presentation of a research project over 18 months in Stage 2 (Years 3 and 4).

The core curriculum includes research methods, ethical considerations in research, statistics and safety. The research projects offered to students are diverse as they may come from the University Clinical Partners, any department within the Faculty of Medicine, Health and Human Sciences, MQ University Hospital and AIHI. The projects focus on making a scholarly contribution to learning health systems and may include projects related to: health systems development and delivery; infrastructure and resource use in healthcare; patient safety and quality; patient and clinician experience of service delivery; patient and professional reported determinants of health and wellbeing; medical education.

Macquarie MD research processes and principles include:

• Developing a group-based research project where students work together, with each student also required to answer a related but different research question and submit individual work for assessment.
• Identifying suitable research projects six to 12 months before the projects commence.
• Allowing students to preference their research project.
• Placing responsibility for ethics approval on supervisors to ensure it is appropriate and obtained in a timely manner.
• Training staff and students on Microsoft teams, which is the primary communication channel and protected storage site for data and documents related to the research projects. For each project, the relevant students and supervisors will form a team, and access to the team will be restricted to appropriate personnel so that data retention and ethical requirements are met.
• Having academic leads for the research project units across the student cohort.
• Showcasing the research in a final symposium in which students present work to a wide audience of peers, staff, clinical partners and external groups.

MD students chose their research topic from a list of projects submitted by interested supervisors. Supervisors nominate the number of students required to complete the project and work with teams of two to four students. The supervisory teams are comprised of both academics from AIHI and Clinicians from MQ Health, to further encourage and foster interdisciplinary relationships.

With guidance from their supervisors, the students devise their own research question on the chosen topic. Over the course of 18 months, the students further explore and develop their own research project by conducting reviews, data audits and/or extensive literature searches. Ten assignments are goal-posted along the pathway of research development and marked by supervisors and moderated by the Unit Convenors, culminating in a final manuscript (to the level of a British Medical Journal (BMJ) Open paper) and a ten-minute oral presentation across the Faculty of Health and Human Sciences, Doctor of Medicine & Doctor of Physiotherapy.

How the students are introduced to the range of research designs

At the end of Year 2, students are introduced to research methodology, alongside patient safety and quality work. Students have a core research curriculum, over a five-week block, to give them a foundation for their research tasks. The subsequent three research units build on their application in each topic area of choice.  Due to the variety of topics, students explore different research methodologies applicable to their individual tasks then work with their supervisory teams, presenting and interpreting work as qualitative and quantitative data.

Number of academic staff and students involved

Approximately 60 students participate in the program per annual intake. The academic staff are interdisciplinary, from across the Macquarie University campus. The average number of supervisory staff required is around 60 staff per cohort, however the actual supervisory staff numbers are fluid as they depend on several factors (exact number of students, and how many students each supervisor takes for each project).  Along with core supervisory staff there are other departments across the University which are also invested in the MD Research Program:

• Advisory Group and Executive Committee, comprising members across diverse integrated areas from within Macquarie University and MQ Health.
• Ethics / Library / Statisticians / Learning and Development Team.

To avoid delays and falling short of student research commitments, ethics needs to be obtained by the supervisors before the projects are selected. Studies ideally avoid live data capture and, where possible, focus on clinical settings, audits, clinical reviews for patient safety and quality improvement.

Learning outcomes: The research units have been designed around a capability framework: four graduate capabilities, each with two capability aspects (see Figure 1).

Figure 1. Macquarie MD Graduate capabilities and aspect

Research-specific learning outcomes, learning activities and assessments are designed to develop and align with the capabilities.

Assessment

Coarse grading is used throughout the Macquarie MD for all assessment tasks. A variety of assessment tasks are used for the MD research program: oral, written and logbook reflections. The final oral presentation is marked by internal and external examiners.

Most tasks will assess two or more Capability Aspects (see Figure 1. above), with a focus and Generic Capability Aspects. Students will receive a coarse grade and feedback for the Capability Aspects assessed in that particular assessment task. The coarse grades used in the Macquarie MD are outlined in Figure 2, below.

Figure 2. Macquarie MD Coarse Grading framework

The Macquarie MD also uses Entrustable Professional Activities (EPAs),  see Appendix.

What is the Program achieving?

Student evaluation: Each cohort of students evaluate the program via a university central survey.

Reflections on how program has evolved so far: Every indication to date has been that the MD Research program has met and exceeded all expectations. All the assessments within the MD Research Program have been reworked in alignment with feedback from supervisors. The AMC favourably reviewed our program in 2020.

Our first cohort of MD students, who commenced in 2018, completed the 18-month MD Research Program by presenting the results of their research at the Doctor of Medicine & Doctor of Physiotherapy Research Symposium on 25 June 2021. This half-day event saw 98 students from both courses present their research project in front of their peers and a panel of internal and external examiners from other universities and Macquarie. Due to COVID-19, this event was moved from face-to-face to Zoom, which proved a successful and dynamic virtual platform. The external supervisors were very forthright in praising the level of scholarly presentation and professionalism of the students.

Goals for future: We would like to be in a position of developing students’ capability to select their own research project by selecting a research team/professor they would like to work with.

Impact of Covid-19

• A major consequence of Covid has been that the students are unable to go to India, which has curtailed some of our planned research partnerships but overall has not affected delivery.
• Some projects that rely on clinical data capture have had to reshape their research questions.
• Planned live delivery of course work and the final research symposium was moved to an online platform.
• The final year group presentations at the research symposium 2021 was the virtual space, adapted for COVID.

APPENDIX

Figure 3. The Macquarie MD Entrustable Professional Activities list

Entrustable Professional Activities

The Macquarie MD also uses Entrustable Professional Activities (EPAs) to assess students. Each EPA is a fundamental clinical task that a student could be entrusted to perform by a clinical /research supervisor. EPAs are assessed by seeking an experienced assessor’s recommendation for the level of supervision the student would require when performing the EPA with real healthcare/research teams in the future using the following coarse scale:

There are 5 Stage 1 EPA and 9 Graduate EPAs in the Macquarie MD as illustrated in Figure 3 with G EPA 3 assessed in the Research Component and an R Level expected.

References

[1] MQ Health is Australia’s first university-owned teaching hospital.

PDF of case studies available here: Research in the Medical Curriculum, Volume 1 – A window on innovation and good practice 2022